The ratio between carcinoma antigen-125 levels in the seminal plasma and serum may be a marker for fertilization in intracytoplasmic sperm injection

Objective: To assess the relationship between tumor marker carcinoma antigen-125 levels in seminal plasma and serum and fertilization rates in an IVF program, using intracytoplasmic sperm injection (ICSI).

Design: A prospective study.

Setting: IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Patient(s): Twenty-five infertile patients with severe oligo-terato-asthenospermia syndrome and 25 fertile male donors.

Intervention(s): None.

Main Outcome Measure(s): Serum and seminal plasma carcinoma antigen-125 concentrations and fertilization rate per cycle.

Result(s): In the infertile group, the seminal plasma carcinoma antigen-125 levels ranged from 22.0 to 1,284.0 U/mL (mean level ± SD, 229.9 ± 274.2 U/mL). In the normospermic fertile male donors, the seminal plasma carcinoma antigen-125 concentrations ranged from 12.2 to 336.7 U/mL (mean level ± SD, 110.1 ± 91.6 U/mL). This difference was statistically significant. The mean ± SD ratio between the seminal plasma/serum carcinoma antigen−125 levels differed significantly between the infertile group (47.9 ± 61.3) and the fertile male donors (5.7 ± 3.5). In the infertile group, the ratio between the seminal plasma/serum carcinoma antigen-125 levels was found to be negatively correlated with the oocyte fertilization rate.

Conclusion(s): The ratio between carcinoma antigen−125 levels in the seminal plasma and serum may be an indirect marker for male infertility and fertilization rate in IVF treatment using ICSI.     

Adherence to antidepressant medications in black and Latino elderly patients.

OBJECTIVE: The purpose of this pilot study was to identify ethnic group differences in nonadherence and to determine predictors of nonadherence to antidepressant medications in older minority-group members. METHODS: Participants were 49 black and 52 Latino subjects over the age of 55 who had been prescribed antidepressant medications within the past 12 months. RESULTS: We found a distinction between intentional nonadherence (e.g., alteration of medication regimen to fit one's needs) and unintentional nonadherence (e.g., forgetfulness/difficulties keeping track of medication regimen). Results suggested that older Latino subjects reported significantly more unintentional nonadherence than older black subjects. However, once other predictors were entered into the model, ethnicity did not remain a significant predictor. No ethnic group differences in intentional nonadherence were suggested. After controlling for ethnicity and medication type, intentional nonadherence was associated with concerns about the side effects of antidepressant medications, the stigma associated with antidepressant medications, and the attribution of lesser importance to antidepressant medications than other medications. Unintentional nonadherence was associated with greater cognitive impairment. CONCLUSIONS: Results suggest that the two ethnic minority groups face similar barriers to adherence to antidepressant medications. Interventions to increase adherence should target the specific type of nonadherence presented by the elderly patients. Some may benefit from memory aids and the assistance of family and friends, others from specific educational interventions about the nature of depression and antidepressant medications.     

Empirical antibiotics against Gram-positive infections for febrile neutropenia: systematic review and meta-analysis of randomized controlled trials

OBJECTIVES: To assess the value of empirical anti-Gram-positive antibiotics for the treatment of febrile neutropenia. METHODS: Systematic review and meta-analysis of randomized controlled trials comparing antibiotics with anti-Gram-positive spectrum to control or placebo, in addition to the same baseline antibiotic regimen in both arms. We searched MEDLINE, EMBASE, LILACS, the Cochrane Library, conference proceedings, and references. No restrictions on inclusion were imposed. Two reviewers independently applied selection criteria, carried out quality assessment, and extracted the data. Relative risks with 95% confidence intervals were pooled using the fixed effect model. The primary outcome assessed was all-cause mortality. RESULTS: Thirteen studies met inclusion criteria, including 2392 participants. Glycopeptides were assessed in nine trials. Empirical anti-Gram-positive antibiotics were assessed for the initial treatment in 11 studies, and for persistent fever in two. No significant difference in all-cause mortality was seen [RR 0.86 (0.58-1.26), seven studies, 852 participants]. Overall failure at end of therapy occurred equally [RR 1.00 (0.79-1.27), six studies, 943 participants]. Failure associated with treatment modifications was more frequent in the control arm when empirical initial glycopeptides were assessed [RR 0.70 (0.61-0.80), five studies, 1178 participants]. Bacterial superinfections, mainly Gram-positive, were detected less frequently in the intervention arm. Adverse events were significantly more common with the additional antibiotic, and nephrotoxicity was significantly more common with additional glycopeptides [RR 1.88 (1.10-3.22), six studies, 1282 participants]. No significant heterogeneity was present in these comparisons. CONCLUSIONS: The use of glycopeptides can be safely deferred until the documentation of a resistant Gram-positive infection.     

Hope for male fecundity: clinically insignificant changes in semen parameters over 10 years at a single clinic while assessing an infertility population

Journal of Assisted Reproduction and Genetics - What is the trend in sperm parameters in a group of men attending a single reproductive center, over a 10-year period? A retrospective study was...     

PNist: interactive volumetric measurements of plexiform neurofibromas in MRI scans

Purpose

Volumetric measurements of plexiform neurofibromas (PNs) are time consuming and error prone, as they require the delineation of the PN boundaries, which is mostly impractical in the daily clinical setup. Accurate volumetric measurements are seldom performed for these tumors mainly due to their great dispersion, size and multiple locations. This paper presents a semiautomatic method for segmentation of PN from STIR MRI scans.

Methods

Plexiform neurofibroma interactive segmentation tool (PNist) is a new tool to segment PNs in STIR MRI scans. The method is based on histogram tumor models computed from a training set.

Results

Experimental results from 28 datasets show an average absolute volume difference of 6.8 % with an average user time of approximately 7 min versus more than 13 min with manual delineation. In complex cases, the PNist user time is less than half in compared to state-of-the-art tools.

Conclusions

PNist is a new method for the semiautomatic segmentation of PN lesions. Its simplicity and reliability make it unique among other state-of-the-art methods. It has the potential to become a clinical tool that allows the reliable evaluation of PN burden and progression.     

ER homeostasis and motility of NSCLC cell lines can be therapeutically targeted with combined Hsp90 and HDAC inhibitors

Background and objectiveLung cancer remains the most common cause of cancer-related death in the world for which novel systemic treatments are urgently needed.Protein homeostasis that regulates protein levels and their fold is critical for cancer cell proliferation and survival. A complex network of cellular organelles and signaling cascades is involved in control of protein homeostasis including endoplasmic reticulum (ER). Thus, proteins in control of ER homeostasis are increasingly recognized as potential therapeutic targets.Molecular chaperone heat shock protein 90 (Hsp90) and histone deacetylase (HDAC) play an important role in ER homeostasis. Previous studies demonstrate that Hsp90 and HDAC inhibitors are individually functional against lung cancer. In this work we suggested that combined Hsp90 and HDAC inhibitors may elevate ER stress thereby enhancing the anti non small lung cancer (NSCLC) activity.Methods and resultsUsing an in vitro cell line model we demonstrated that 17-DMAG (HSP90 inhibitor) co-administration with PTACH (HDAC inhibitor) caused elevated ER stress (immunoblotting) (more than 110%↑, p < 0.05) accompanied by apoptotic cell death (Annexin V) (7–21%↑, p < 0.05). Moreover, 17-DMAG/PTACH treated cells lost the ability to migrate (scratch test) (57–85%↓ of scratch closure, p < 0.05).ConclusionsOur findings provide proof-of-concept that targeting ER homeostasis is therapeutically beneficial in lung cancer cell lines. Indeed, the elevated ER stress caused by 17-DMAG/PTACH combined treatment leads to increased cell death of NSCLC cell lines compared to the application of the drugs separately.